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Flat Feet...less medical jargon in a 'Quick Glance' format!
Causes: It is a common condition. In infants and toddlers, the longitudinal arch is not developed and the condition is normal. The arch develops in childhood, and by adulthood, most people have developed normal arches. When the condition persist, the majority are considered variations of normal. Most feet are flexible and an arch appears when the person stands on his or her toes. Stiff, inflexible, or painful feet may be associated with other conditions and require attention. Painful flat feet in children may be caused by a condition called tarsal coalition. In tarsal coalition, two or more of the bones in the foot fuse together and limiting motion. Most of the time this condition does not cause pain or other problems. It may be associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other after they have been worn long enough for the foot position to remodel their shape. Foot pain, ankle pain, or lower leg pain, especially in children, may be a result of flat feet and should be evaluated by a health care provider. Treatment: Flexible feet with this condition that are painless do not require treatment. If pain due to this condition occurs, an arch supporting insert in the shoe can bring relief. With the increased interest in running, many shoe stores carry shoes for normal feet and pronated feet. The shoes designed for pronated feet make long distance running easier and less tiring as they correct for the positional abnormality.
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Rigid or painful flat feet require the evaluation of a health care provider. The exact treatment depends on the cause of the condition. For tarsal coalition, treatment starts with rest and possibly casting. If this fails to improve the pain, surgery may be necessary to either resect the fused bone or actually completely fuse several bones in a corrected position. For problems with the posterior tibial tendon, treatment may start with rest, anti-inflammatory medications, and shoe inserts or ankle braces. In more advanced cases, surgery may be necessary to clean the tendon, repair the tendon, or actually fuse some of the joints of the foot in a corrected position in very advanced cases.
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